Diagnosis and Treatment

Evaluation and diagnostic testing

When patients have symptoms such as microscopic or obvious blood in their urine, urinary frequency/urgency, bladder pain, or fatigue/weight loss that can mimic urinary tract infections, enlargement of the prostate in men, or common lower urinary tract symptoms in women, three tests are typically performed to make a diagnosis:

First, a urine test called cytology (similar to a Pap smear in women to evaluate for cervical cancer) is performed to detect cancer cells in the urine. This test takes two or three days for a result and in many cases, is inconclusive.

Most patients will require an imaging test that evaluates the lining of the upper urinary tract (such as a CT scan, MRI, or ultrasound) CT is the preferred test.

A cystoscopy performed by placing a tiny flexible lighted telescope into the urethra in the clinic and inspecting the urethra and bladder, often in the urologist’s office. If a tumor is seen or a suspicious area is identified, your doctor will then schedule a second cystoscopy to be performed in the operating room under anesthetic to remove the tumor allowing for a diagnosis and in some cases, therapeutic treatment of the tumor by completely removing it. This procedure can also be performed in the clinic setting as part of a surveillance plan for already-diagnosed patients.

Patients also benefit by having a molecular pathologist perform a genetic evaluation of their tumor to help guide personalized treatment decisions.

Medical management

Treatment for bladder cancer is based on the grade/stage of the tumor and may include:

Repeat bladder scraping to assure that all of the cancer in the bladder is removed*

Injecting chemotherapy into the bladder to help prevent bladder cancer recurrence

*The T1 stage, in which the tumor has grown from the layer of cells lining the bladder into the connective tissue below, requires complete scraping. In this case, we use the procedure as a restaging tool because recent research indicates the risk of understaging patients with a T1 stage is high. Some will need a more aggressive treatment plan such as neo-adjuvant chemotherapy followed by bladder removal.

Surgery

We are innovators in the surgical care of patients with bladder cancer, employing robotic and minimally invasive surgery, intracorporeal urinary diversion, bladder replacement surgery, and surgeries designed to minimize the functional impact of bladder removal on the quality of life of patients.

We also perform at least 75 robotic cystectomies annually. This high volume means that our urologic cancer surgeons have the greatest experience in providing optimal care. And because of our multidisciplinary approach to care, we coordinate all treatment including neo-adjuvant chemotherapy prior to surgery and a return to normal life afterward.

Still have questions?

The nurses at Cancer AnswerLine™ have answers. Call 1-800-865-1125 and you'll get a personal response from one of our registered nurses, who have years of experience in caring for people with cancer.